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During this elective the upper level resident will act a supervising physician in charge of care for a portion of the pediatric inpatients, including general pediatrics and the NICU. Although there is no PICU at JFK, the acuity of disease on the general pediatrics floor is significant and requires experience similar to that needed in a PICU in the US. There are also opportunities to work in the pediatric area of the Emergency Department. In the afternoon, the resident will be expected to help out in the outpatient department if their clinical duties are completed on the floor and NICU. The resident will be expected to give 1 - 2 lectures and lead 1 journal club for the pediatric staff in Liberia. The staff includes medical students, interns, residents, PA’s, and Liberian pediatricians. Throughout the elective the resident will be supervised by the Liberian pediatrician and likely by a visiting US pediatrician.
The organization Superemos coordinates a yearly medical brigade to provide pediatric specialty care to underserved communities in and around the city of Esteli. The brigade is 3 weeks long but participants can go from 1-3 weeks. The members of the brigade head out daily to the poorest Barrios and communities in the area. We set up a small clinic in the schools or Puestos de Salud (medical outposts). We commonly are seeing the equivalent of sick visits to a primary care clinic. We also distribute anti-parasitic meds, and tooth brushes. We do some basic health and hygiene teaching. We are often accompanied by a doctor or nurse from the Nicaraguan Ministry of Health (MINSA), who refer complicated patients to us. Once we make our assessment we coordinate with the local staff and Superemos to get the necessary care for the patients.
The cooperation and support of the local medical staff is critical and helps makes the efforts of the brigade sustainable. The day usually consists of departure at 7:30am and return to Superemos around 4 pm. We see between 40 and 80 children per day. There are also adult providers who are providing similar services to the adults in the communities. We are in the beginning phases of a project with MINSA to facilitate teaching and education of community health workers. This includes giving short lectures and providing written material for them about the more common diseases they are likely to see in their communities.
There are 2 “minihospitals” at Shoulder to Shoulder in Honduras with maternity care, lab, x-ray, dental care and 24 hour emergency care in Honduras and 9 other smaller clinics. The Department of Family Medicine has established a longitudinal relationship here. There have been over 4000 volunteers from many countries travel to our sites in Honduras. The purpose of these brigades is quite different from the usual intermittent, random medical brigade model so common in the developing countries. Our mission is to provide education to students, education for our medical staff and community health providers, and run our Children’s Health Initiative.
Thuy Bui, MD, Director, Global Health and Underserved Populations Track for the internal medicine residents, has a longitudinal relationship with this region.
This is a tertiary care hospital affiliated with the University of the Philippines Manila. You see a variety of tropical diseases, including TB and malaria. There is also an opportunity to participate in field research on the other islands, e.g., treatment of parasites in children.
From their website: “Training, service and research are the three major thrusts of the department in consonance with the goals of the Philippine General Hospital and the College of Medicine of the University of the Philippines. Being the referral center of practically the whole Philippines, trainees in the department are exposed to a myriad of cases including the rarest and the most complicated of its kind. This clinical experience is complemented by the regular consultant rounds, subspecialty services, lectures for the house staff, seminars, workshops and other learning opportunities. The faculty staff of the department is composed of 66 noted pediatricians, a number of which are holders of postgraduate degrees. Aside from the traditional residency program, trainees can avail of a combined residency and masteral program. Residents can obtain any masteral degree while pursuing residency. In fact, the department also offers its own masters in child health. Further training can be obtained through any of the department's sixteen subspecialty programs.”
Mozambigue in Beira is a general outpatient clinic where 40% of patients are less than 18 years of age. They see about 100 patients a day with a variety of interesting diagnoses. U Pittsburgh is a major partner here. From web newsletter: “Recently, the HIV/AIDS Twinning Center and partners at the Universidade Católica de Moçambique (UCM) and the University of Pittsburgh in Pennsylvania celebrated the opening of a new HIV/AIDS clinic and training center in Mozambique. Renovated with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), St. Luke’s Health Center officially opened its doors on June 17, 2009. This center works to expand accessibility of high quality primary care and HIV/AIDS services to people in the Sofala Province.”
The Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT) is a joint public-private partnership between the Region of Sicily, through Civico and Cervello hospitals in Palermo, and UPMC, an integrated global health enterprise headquartered in Pittsburgh, USA, and one of the leading nonprofit health systems in the United States. Over the past decade, ISMETT has become one of the leading organ transplant centers in Europe and a major referral center for other Mediterranean countries. More than 1000 transplant procedures have been performed at ISMETT with outstanding clinical results. ISMETT's one-year survival rate for liver transplant recipients is the highest in Italy.
The Chinle Comprehensive Health Care Facility (CCHCF) is based in Chinle, Arizona (Northeast Arizona near Canyon De Chelly National Monument). The CCHCF is a 60 bed hospital which serves as the health care hub for the region. The medical staff includes Family Physicians, Internists, Pediatricians, General Surgeons, OB/GYN's, Anesthesiologists, and a Psychiatrist. In addition to routine outpatient and inpatient primary care, services available to our patients include:Adult Intensive Care (4 bed unit), General Surgery (including laparoscopic surgery), routine and operative Obstetrics (700 deliveries/year), and 24-Hour Emergency Room Services (25,000 patients per year). Health care services are provided to approximately 37,000 active users. Strong Navajo cultural traditions exist within the community, offering an opportunity to learn the Navajo language, or to learn about traditional Navajo medicine.
Ericka Fink, MD firstname.lastname@example.org
Catalina Hoyos, MD email@example.com
Jen Wolford, DO, MPH firstname.lastname@example.org
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